Black lung benefit reform left out of health act debate

CHARLESTON, W.Va. -- Republican presidential candidate Mitt Romney promises that one of his first acts in office will be to repeal the Affordable Care Act.

In his campaign for West Virginia governor, Republican Bill Maloney also bashes the law. So does GOP Senate candidate John Raese.

Seldom mentioned in the debate over health care, though, is that repealing the act would remove a major new provision of black lung law that has made it easier for disabled miners or their widows to get federal benefits for the deadly disease.

At issue is little-noticed language slipped into the health-care bill by the late Sen. Robert C. Byrd, D-W.Va., to help with longstanding problems faced by miners and widows seeking black lung benefits.

"Repeal of the Affordable Care Act would strip away access to critically important benefits for miners with black lung and their widows," said Phil Smith, a spokesman for the United Mine Workers union.

The UMW has not endorsed a presidential candidate, but did endorse Democratic Gov. Earl Ray Tomblin and Sen. Joe Manchin in their re-election bids.

Smith said the UMW was not a huge supporter of the health-care act. He said the union was "disappointed with the overall law when it was passed because we thought it did too much to keep insurance companies in charge of health care and it did too little to provide affordable, accessible, high quality care to every American, regardless of their ability to pay."

But the union supported the black-lung provision, and now opposes repeal of the entire law.

"It took 30 years to restore the ability for most victims to get black lung benefits after the last Republican attack on them," Smith said. "With this insidious disease once again on the rise, miners and their families cannot afford to lose access to federal black lung benefits again."

Black lung, or coal workers' pneumoconiosis, is an irreversible and potentially deadly disease caused by exposure to coal dust.

Under federal law, coal miners who have black lung disease are entitled to disability payments funded by the industry.

Miners and widows tell horror stories about the difficult process of obtaining benefits. Coal companies can challenge their applications for benefits, and the process is complicated and time consuming.

As part of the federal health-care reform law, Byrd succeeded in reversing Reagan-era changes to the black lung benefits program that had made it harder for miners or their widows to obtain those benefits.

Under Byrd's amendment, the law reverts to assuming that miners with at least 15 years' experience who have a disabling respiratory condition have black lung disease. Companies can overcome that assumption by proving that the miner didn't really work 15 years in the mines or that the disability was caused by something else, such as smoking.

Byrd's amendment also keeps widows whose husbands were receiving benefits at the time of their deaths from having to re-apply after their husbands die. Both changes apply only to cases where benefit applications were filed after Jan. 1, 2005, and were pending on or after last month's passage of the health-care reform law.

Citing data from the Black Lung Clinic at Washington and Lee University's School of Law, Bishop said that more than 700 disabled coal miners or their surviving spouses are already receiving benefits under Byrd's language. Bishop noted a report in Foreign Policy magazine that said the outcome of this year's presidential election "could come down to one thing: coal."

"That doesn't mean coal miners, however," Bishop wrote. "Although both President Obama and Mitt Romney have pledged their support for coal, the issue of black lung -- either its causes or compensation for those who contract the disease -- has not arisen in this campaign."